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Let's say your insurance premiums are $300.00 per month, and you've paid them faithfully for 5 years. Then you require major medical attention, and the cost of all (doctors & hospital) is $150K.
You've only paid $18,000.00 in premiums. This would be a great deal for the insurance company.
This would leave you with $132K to pay, and you'll have no insurance coverage with the company that you once had.
Wouldn't it be better for the company to be fined at a higher rate than your medical bill, the bill paid, and the government takes the fine overage and places it in a medical care fund to help pay for medicare and medicaid? Plus the company be made to continue to insure you as long as you continue your premium payments.